The 78 modifier is defined as the following: UNPLANNED RETURN TO THE OPERATING/PROCEDURE ROOM BY THE SAME PHYSICIAN FOLLOWING INITIAL PROCEDURE FOR A RELATED PROCEDURE DURING THE POSTOPERATIVE PERIOD. Since the subsequent surgery was directly related to the initial surgery, the 78 modifier was the correct modifier to append to the CPT code for the trans-metatarsal amputation, CPT code 28805. After all, this was an unplanned return to the operating room. I evaluated the patient post operatively and I am wondering which date should I be using for the 90-day global period?” For the subsequent surgery, I used Modifier 78. The result is a return to the operating room for a right trans-metatarsal amputation. The site did not heal, and a new infection developed at the amputation site. “I performed a partial 1st ray amputation that included the hallux and part of the 1st metatarsal.
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